Marleen, S; Dias, C; Nandasena, R; MacGregor, R; Allotey, J; Aquilina, J; Khalil, A; Thangaratinam, S
(2021)
Association between chorionicity and preterm birth in twin pregnancies: a systematic review involving 29 864 twin pregnancies.
BJOG, 128 (5).
pp. 788-796.
ISSN 1471-0528
https://doi.org/10.1111/1471-0528.16479
SGUL Authors: Khalil, Asma
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Abstract
Background The perinatal mortality and morbidity among twins vary by chorionicity. Although it is considered that monochorionicity is associated with an increased risk of preterm birth in twin pregnancies, no systematic review exists evaluating this association. Objectives This systematic review was undertaken to assess the association between preterm birth and chorionicity in twin pregnancies. Search strategy We searched the electronic databases from January 1990 to July 2019 without language restrictions. Selection criteria All studies on twin pregnancies where chorionicity and preterm birth were evaluated were included. Data collection and analysis Findings are reported as odds ratios with 95% confidence intervals. The estimates are pooled using random‐effects meta‐analysis. Main results From 13 156 citations, we included 39 studies (29 864 pregnancies). Monochorionicity was significantly associated with increased risk of preterm birth at ≤28, ≤32, ≤34 and <37 weeks in women asymptomatic and symptomatic for preterm labour (odds ratio [OR] 2.14, 95% CI 1.52–3.02, I2 = 46%, OR 1.55, 95% CI 1.27–1.89 I2 = 68%, OR 1.47, 95% CI 1.27–1.69, I2 = 60%, OR 1.66, 95% CI 1.43–1.93, I2 = 65%, respectively). Among those asymptomatic for preterm labour, significantly increased odds of preterm birth were seen for monochorionicity at gestations ≤34 weeks (OR 1.85, 95% CI 1.42–2.40, I2 = 25%) and <37 weeks (OR 1.75, 95% CI 1.22–2.53, I2 = 61%). Sensitivity analysis showed significantly increased odds of spontaneous preterm birth at ≤34 and <37 weeks for monochorionicity (OR 1.25, 95% CI 1.01–1.55, I2 = 0% and OR 1.41, 95% CI 1.13–1.78, I2 = 0%). Conclusions Monochorionicity is significantly associated with preterm birth at all gestations.
Item Type: | Article | ||||||||
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Additional Information: | © 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | ||||||||
Keywords: | Twins, chorionicity, multiple pregnancy, preterm birth, preterm labour, ultrasound predictors, 11 Medical and Health Sciences, Obstetrics & Reproductive Medicine | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | BJOG | ||||||||
ISSN: | 1471-0528 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||||
PubMed ID: | 32888235 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/112373 | ||||||||
Publisher's version: | https://doi.org/10.1111/1471-0528.16479 |
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